IN A newborn infant who has signs of blood loss with laboratory confirmation and abdominal distention, the surgeon should suspect intraperitoneal hemorrhage from rupture of an abdominal viscus. As this treatise suggests, rupture of the spleen must be considered even though the more common source of bleeding would be caused from injury to the liver. In a study of 2,000 fetal and neonatal deaths, Potter1 found that in 14.3% autopsy showed death was secondary to traumatic hemorrhage. In this group there were 28 lacerations of abdominal organs. In 24 of these visceral injuries the organ involved was the liver. Hemorrhage from the spleen was not mentioned in this series. Hemoperitoneum from splenic rupture in a newborn with an otherwise normal spleen is an extreme rarity. There are scattered instances of spleens rupturing secondary to erythroblastosis fetalis, syphilis, and leukemia, where, as in the adult with malaria or infectious mononucleosis,